The Skeptics' Guide to EM
JULY 3, 2021
Paramedics managed to get return of spontaneous circulation after a single defibrillation, but the patient is still comatose on arrival. This is the original Target Temperature Management (TTM) trial by Nielson et al NEJM 2013. The charge nurse turns to you and asks: should I grab the ice packs?
Dr. Smith's ECG Blog
OCTOBER 28, 2013
She was found to be in ventricular fibrillation and was defibrillated 8 times without a single, even transient, conversion out of fibrillation. She was immediately intubated during continued compressions, then underwent a 9th defibrillation, which resulted in an organized rhythm at 42 minutes after initial arrest. References : 1.
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EMDocs
JANUARY 16, 2024
The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field. The patient is moved over to the stretcher and connected to the monitors and defibrillator. 2013 Jan 24;368(4):394]. What would your next steps be? Resuscitation.
EMDocs
SEPTEMBER 23, 2023
Patients with Brugada syndrome should have a prompt cardiology consultation for consideration of implantable defibrillator placement due to the high risk of sudden cardiac death. ECGpedia , 22 May 2013, [link]. Heart Rhythm. 2013;10(12):1932-1963. Cardiac Histological Substrate in Patients With Clinical Phenotype of Brugada Syndrome.
Dr. Smith's ECG Blog
OCTOBER 20, 2013
She was never seen to be in ventricular fibrillation and was never defibrillated. Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. With ventilations and epinephrine, she regained a pulse. She was hypotensive in the ED and her bedside echo showed a normal RV and LV. BP gradually rose.
Dr. Smith's ECG Blog
MAY 6, 2019
Cardioversion/defibrillation. This definition was changed following an expert consensus panel in 2013 — so that at the present time, all that is needed to diagnose Brugada Syndrome is a spontaneous or induced Brugada-1 ECG pattern, without need for additional criteria. Acute febrile illness. Variations in autonomic tone. Hypothermia.
Dr. Smith's ECG Blog
JANUARY 30, 2019
This definition was changed following an expert consensus panel in 2013 — so that at the present time, all that is needed to diagnose Brugada Syndrome is a spontaneous or induced Brugada-1 ECG pattern, without need for additional criteria.
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